title: Educational videos to reduce racial disparities in ICD therapy via innovative designs (VIVID): a randomized clinical trial.
abstract: BACKGROUND
  Black individuals eligible for an implantable cardioverter/defibrillator (ICD) are considerably less likely than white individuals to receive one. This disparity may, in part, be explained by racial differences in patient preferences. We hypothesized that a targeted patient-centered educational video could improve knowledge of sudden cardiac arrest (SCA) and ICDs and reduce racial differences in ICD preferences. We conducted a pilot study to assess the feasibility of testing this hypothesis in a randomized trial.
  
  
  METHODS
  We created a video that included animation, physician commentary, and patient testimonials on SCA and ICDs. The primary outcome was the decision to have an ICD implanted as a function of race and intervention. Between January 1, 2011, and December 31, 2011, 59 patients (37 white and 22 black) were randomized to the video or health care provider counseling/usual care.
  
  
  RESULTS
  Relative to white patients, black patients were younger (median age, 55 vs 68 years) and more likely to have attended college or technical school. Baseline SCA and ICD knowledge was similar and improved significantly in both racial groups after the intervention. Black patients viewing the video were as likely as white patients to want an ICD (60.0% vs 79.2%, P = .20); and among those in the usual care arm, black patients were less likely than white patients to want an ICD (42.9% vs 84.6% P = .05).
  
  
  CONCLUSIONS
  Among individuals eligible for an ICD, a video decision aid increased patient knowledge and reduced racial differences in patient preference for an ICD.
authors.affiliation: Duke Clinical Research Institute, Durham, NC 27710, USA. kevin.thomas@duke.edu
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Thomas
authors.forename: Louise O
authors.initials: LO
authors.lastname: Zimmer
authors.forename: David
authors.initials: D
authors.lastname: Dai
authors.forename: Sana M
authors.initials: SM
authors.lastname: Al-Khatib
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Allen LaPointe
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
mesh_terms: D000368:Aged; D016757:Death, Sudden, Cardiac / Q000208:ethnology / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000208:ethnology / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D044469:Racial Groups; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology